Baptist Health Louisville (Release of Information) fax number

Fax destination details

Department

Release of Information (Health Information Management)

Purpose

Medical records release / authorization for use/disclosure of PHI

Form

Authorization for Use and/or Disclosure of Protected Health Information (PHI) — Authorization for Use and/or Disclosure of Protected Health Information (PHI) Release of Information

Address

Baptist Health Release of Information, PO Box 436147, Louisville, KY 40253

Voice phone

Phone: (502) 253-4828; Toll-Free: (833) 998-1257

Website

Visit organization website

Before you send

• Confirm that this exact department handles your document or request.
• Check the organization website or call its main line for the current fax number.
• Include a cover sheet and any case, member, claim, or form reference required.
• Keep the delivery confirmation with your submission records.

Complete the form with patient/representative details, sign and date, specify which records to release, the recipient (organization or person), and select delivery method (Paper via US Mail, CD via US Mail, Fax, MyChart, or Email). Include dates of service if needed and any required identifiers. Submit to Baptist Health Release of Information. Expect processing within the timelines set by HIPAA/KRS; the form emphasizes handwritten signatures and secure transmission.

Official form instructions are published as a downloadable file on the organization's website.